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What is genital herpes?
Herpes is a sexually transmitted infection (STI) caused
by the herpes simplex viruses type 1 (HSV -1) and type 2
(HSV-2). Most individuals have no or only minimal signs
or symptoms from HSV-1 or HSV-2 infection. When signs do
occur, they typically appear as one or more blisters on
or around the genitals or rectum. The blisters break,
leaving tender ulcers (sores) that may take two to four
weeks to heal the first time they occur. Typically,
another outbreak can appear weeks or months after the
first, but it almost always is less severe and shorter
than the first episode. Although the infection can stay
in the body indefinitely, the number of outbreaks tends
to go down over a period of years.
How is genital herpes spread?
HSV-1 and HSV-2 can be found and released from the sores
that the viruses cause, but they also are released
between episodes from skin that does not appear to be
broken or to have a sore. A person almost always gets
HSV-2 infection during sexual contact with someone who
has a genital HSV-2 infection. HSV-1 causes infections
of the mouth and lips, so-called "fever blisters." A
person can get HSV-1 by coming into contact with the
saliva of an infected person. HSV-1 infection of the
genitals almost always is caused by oral-genital sexual
contact with a person who has the oral HSV-1 infection.
How common is genital herpes?
Results of a recent, nationally representative study
show that genital herpes infection is common in the
United States. Nationwide, 45 million people ages 12 and
older, or one out of five of the total adolescent and
adult population, are infected with HSV-2.
HSV-2 infection is more common in women (approximately
one out of four women) than in men (almost one out of
five). This may be due to male-to-female transmission
being more efficient than female-to-male transmission.
HSV-2 infection also is more common in blacks (45.9%)
than in whites (17.6%). Race and ethnicity in the United
States correlate with other, more fundamental
determinants of health such as poverty, access to good
quality health care, behavior for seeking health care,
illicit drug use, and living in communities with a high
prevalence of STDs.
Since the late 1970s, the number of Americans with
genital herpes infection has increased 30%. The largest
increase is currently occurring in young white teens.
HSV-2 infection is now five times more common in 12- to
19-year-old whites, and it is twice as common in young
adults ages 20 to 29 than it was 20 years ago.
Is genital herpes serious?
HSV-2 usually produces only mild symptoms or signs or no
symptoms at all. However, HSV-2 can cause recurrent
painful genital sores in many adults, and HSV-2
infection can be severe in people with suppressed immune
systems. Regardless of severity of symptoms, genital
herpes frequently causes psychological distress in
people who know they are infected.
In addition, HSV-2 can cause potentially fatal
infections in infants if the mother is shedding virus at
the time of delivery. It is important that women avoid
contracting herpes during pregnancy because a first
episode during pregnancy causes a greater risk of
transmission to the newborn. If a woman has active
genital herpes at delivery, a cesarean delivery is
usually performed. Fortunately, infection of an infant
from women with HSV-2 infection is rare.
In the United States, HSV-2 may play a major role in the
heterosexual spread of HIV, the virus that causes AIDS.
Herpes can make people more susceptible to HIV
infection, and it can make HIV-infected individuals more
infectious.
What happens when someone is infected with
genital herpes?
Most people infected with HSV-2 are not aware of their
infection. However, if signs and symptoms occur during
the first episode, they can be quite pronounced. The
first episode usually occurs within two weeks after the
virus is transmitted, and the sores typically heal
within two to four weeks. Other signs and symptoms
during the primary episode may include a second crop of
sores, or flu-like symptoms, including fever and swollen
glands. However, most individuals with HSV-2 infection
may never have sores, or they may have very mild signs
that they don't even notice or that they mistake for
insect bites or a rash.
Most people diagnosed with a first episode of genital
herpes can expect to have several symptomatic
recurrences a year (typically four or five). These
recurrences usually are most noticeable within the first
year following the first episode.
How is genital herpes diagnosed?
The signs and symptoms associated with HSV-2 can vary
greatly. Health care providers can diagnose genital
herpes by visual inspection if the outbreak is typical,
and by taking a sample from the sore(s). HSV infections
can be difficult to diagnose between outbreaks. Blood
tests which detect HSV-1 or HSV-2 infection may be
helpful, although the results are not always clear cut.
Is there a cure for herpes?
There is no treatment that can cure herpes, but
antiviral medications can shorten and prevent outbreaks
during the period of time the person takes the
medication.
How can people protect themselves against infection?
The consistent and correct use of latex condoms can help
protect against infection. However, condoms do not
provide complete protection because the condom may not
cover the herpes sore(s), and viral shedding may
nevertheless occur. If either you or your partner have
genital herpes, it is best to abstain from sex when
symptoms or signs are present, and to use latex condoms
between outbreaks.
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